Chronic Pain, Addiction and Zohydro

Chronic Pain, Addiction and Zohydro: In the May 29 edition of the New England Journal of Medicine, ASAM member Yngvild Olsen, MD, MPH penned an article on the challenges surrounding the FDA’s contentious approval of Zohydro. Dr. Olsen remarks on the backlash to the FDA’s decision, from state to grassroots levels. She explains how the response to the Zohydro approval has highlighted the complex intersection between pain and addiction and how they will “remain significant and interconnected clinical and public health challenges for the foreseeable future.” Dr. Olsen offers a number of potential policy responses including medical board model policies on opioids for pain and addiction, better screening for addiction by pain physicians and better screening and treatment of pain where opioids are used to treat addiction.  She also proposes a new physician specialty fellowship on chronic pain and addiction.

ASAM’s Take:  Dr. Olsen makes a compelling case that actions taken to treat the opioid overdose epidemic need not be in conflict with appropriate treatment of chronic pain. Like Dr. Olsen, ASAM supports prescriber education on safe prescribing of opioids for chronic pain including assessment of addiction and its risk potential.  Further, ASAM believes this content should be included in medical school and residency programs.  ASAM also supports full use of PDMPs so that prescribers have access to information to assure safe prescribing.  ASAM’s Public Policy Statement on Measures to Counteract Prescription Drug Diversion, Misuse and Addiction is available on the ASAM website.  

What you can do: Clinicians can take advantage of the CME available through ASAM’s e-Live Learning Center to hone their knowledge and skills on the complex intersection of pain and addiction including the following: 

• Pain and Addiction: Common Threads – ASAM has offered this course for 14 years. The audio and slides from the 2014 course entitled “The Agony and the Partial Agonist” is available on ASAM’s e-Live Learning Center and provides 8 hours of CME.
• ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care – this is a three-hour course that is available free of charge.  This course is not intended to advocate for the use of Extended-Release/Long-Acting (ER/LA) Opioids, but to ensure proper education about safe prescribing practices should a medical provider determine that ER/LA Opioids are the best course of treatment.